Poor Nutritional Status Before and During Chemotherapy Leads to Worse Prognosis in Unresectable Advanced or Recurrent Colorectal Cancer

Abstract

This study aimed to clarify the relationship between host nutritional status prior to first-line chemotherapy and therapeutic effect, and, whether these nourishment indexes could become factors that predict long-term convalescence in metastastic or recurrent colorectal cancer. It has previously been reported that postoperative complications and long-term prognosis of patients with gastrointestinal malignancies may be affected by their nutritional status. But, there is little information regarding the relationship between prognosis, nutritional status, and immunocompetence in metastastic or recurrent colorectal cancer. Ninety patients who had measurable target lesions underwent resection for primary colorectal cancer in our institution, between April 2007 and March 2013. The indicators of host nutritional status were body weight (BW), body mass index (BMI), serum albumin, Onodera's prognostic nutritional index (OPNI), and Glasgow Prognostic Score (GPS). The indicators of host immunocompetence were total lymphocyte counts, total neutrophil counts, and granulocytes/lymphocytes ratio (G/L ratio). The median overall survival (OS) was 32.5 months, and the median progression-free survival was 10.9 months. The relative change of target lesions was associated with BW, BMI, and OPNI. Furthermore, there was strong correlation between the change ratio of the serum carcinoembryonic antigen (CEA) level before and after chemotherapy administration and BMI. BW, BMI, serum albumin level, OPNI, and GPS were significantly associated with overall survival (OS). Poor nutritional status and suppressive immunocompetence are associated with ineffective chemotherapy.